The PHIN photoinjector for the CTF3 Drive beam

A new photoinjector for the CTF3 drive beam has been designed and is now being constructed by a collaboration among LAL, CCLRC and CERN within PHIN, the second Joint Research Activity of CARE. The photoinjector will provide a train of 2332 pulses at 1.5 GHz with a complex timing structure (sub-trains of 212 pulses spaced from one another by 333 ps or 999 ps) to allow the frequency multiplication scheme, which is one of the features of CLIC, to be tested in CTF3. Each pulse of 2.33 nC will be emitted by a Cs2Te photocathode deposited by a co-evaporation process to allow high quantum efficiency in operation (>3% for a minimum of 40 h). The 3 GHz, 2 1/2 cell RF gun has a 2 port coupler to minimize emittance growth due to asymmetric fields, racetrack profile of the irises and two solenoids to keep the emittance at the output below 20 p.mm.mrad. The laser has to survive very high average powers both within the pulse train (15 kW) and overall (200 W before pulse slicing). Challenging targets are also for amplitude stability (<0.25% rms) and time jitter from pulse to pulse (<1ps rms). An offline test in a dedicated line is foreseen at CERN in 2007

First Results from Commissioning of the Phin Photo Injector for CTF3

Installation of the new photo-injector for the CTF3 drive beam (PHIN) has been completed on a stand-alone test bench. The photo-injector operates with a 2.5 cell RF gun at 3 GHz, using a Cs2Te photocathode illuminated by a UV laser beam. The test bench is equipped with transverse beam diagnostic as well as a 90-degree spectrometer. A grid of 100 micrometer wide slits can be inserted for emittance measurements. The laser used to trigger the photo-emission process is a Nd:YLF system consisting of an oscillator and a preamplifier operating at 1.5 GHz and two powerful amplifier stages. The infrared radiation produced is frequency quadrupled in two stages to obtain the UV. A Pockels cell allows adjusting the length of the pulse train between 50 nanoseconds and 50 microseconds. The nominal train length for CTF3 is 1.272 microseconds (1908 bunches). The first electron beam in PHIN was produced in November 2008. In this paper, results concerning the operation of the laser system and measurements performed to characterize the electron beam are presented

An Isolator System for minimally invasive surgery: the new design

Background - The risk of obtaining a postsurgical infection depends highly on the air quality surrounding the exposed tissue, surgical instruments, and materials. Many isolators for open surgery have been invented to create a contained sterile volume around the exposed tissue. With the use of an isolator, a surgical procedure can be performed outside sterile environments. The goal of this study was to design an Isolator System (IS) for standard laparoscopic instruments while instrument movements are not restricted. Methods - The developed IS consists of a sleeve to protect the instrument shaft and tip and a special balloon to protect the incision and trocar tube. A coupling mechanism connected at the sleeve allows instrument changes without contamination of the isolated parts. Smoke tests were performed to show that outside air does not enter the new IS during a simulated laparoscopic procedure. Eight test runs and one baseline run inside a contained volume filled with thick smoke were performed to investigate whether smoke particles entered the Isolator System. Filters were used to identify smoke entering the Isolator System. Results - Seven filters showed no trace of smoke particles. In one test run, a part of the IS loosened and a small brown spot was visible. The filter from the baseline run was completely covered with a thick layer of particles, proving the effectiveness of the test. During all test runs, the isolated instrument was successfully locked on and unlocked from the isolated trocar. Instrument movements gave no complications. After removal of the isolated instrument, it took three novices an average of 3.1 (standard deviation (SD), 0.7) seconds to replace it correctly on the isolated trocar. Conclusions - The designed IS for laparoscopy can increase sterility in environments where sterility cannot be guaranteed. The current design is developed for laparoscopy, but it can easily be adapted for other fields in minimally invasive surgery.Biomechanical EngineeringMechanical, Maritime and Materials Engineerin

Classification of primary and incisional abdominal wall hernias

A classification for primary and incisional abdominal wall hernias is needed to allow comparison of publications and future studies on these hernias. It is important to know whether the populations described in different studies are comparable.Comparative StudyConsensus Development ConferenceJournal ArticleReviewSCOPUS: ar.jinfo:eu-repo/semantics/publishe

Alimentation

Pour donner une image fidèle de l’alimentation des Berbères depuis les origines et suivre son évolution il aurait fallu disposer de documents et de textes qui font malheureusement défaut, aussi plutôt que de se livrer à une étude diachronique impossible à rédiger dans l’état actuel de la recherche nous avons choisi de présenter ce que l’on sait de l’alimentation des Paléoberbères des temps préhistoriques antérieurs à l’élevage et à l’agriculture puis de regrouper nos connaissances sur l’alime..

EuraHS: the development of an international online platform for registration and outcome measurement of ventral abdominal wall hernia repair

Background Although the repair of ventral abdominal wall hernias is one of the most commonly performed operations, many aspects of their treatment are still under debate or poorly studied. In addition, there is a lack of good definitions and classifications that make the evaluation of studies and meta-analyses in this field of surgery difficult. Materials and methods Under the auspices of the board of the European Hernia Society and following the previously published classifications on inguinal and on ventral hernias, a working group was formed to create an online platform for registration and outcome measurement of operations for ventral abdominal wall hernias. Development of such a registry involved reaching agreement about clear definitions and classifications on patient variables, surgical procedures and mesh materials used, as well as outcome parameters. The EuraHS working group (European registry for abdominal wall hernias) comprised of a multinational European expert panel with specific interest in abdominal wall hernias. Over five working group meetings, consensus was reached on definitions for the data to be recorded in the registry. Results A set of well-described definitions was made. The previously reported EHS classifications of hernias will be used. Risk factors for recurrences and co-morbidities of patients were listed. A new severity of comorbidity score was defined. Post-operative complications were classified according to existing classifications as described for other fields of surgery. A new 3-dimensional numerical quality-of-life score, EuraHS-QoL score, was defined. An online platform is created based on the definitions and classifications, which can be used by individual surgeons, surgical teams or for multicentre studies. A EuraHS website is constructed with easy access to all the definitions, classifications and results from the database. Conclusion An online platform for registration and outcome measurement of abdominal wall hernia repairs with clear definitions and classifications is offered to the surgical community. It is hoped that this registry could lead to better evidence-based guidelines for treatment of abdominal wall hernias based on hernia variables, patient variables, available hernia repair materials and techniques

Influence of Reoperations on Long-Term Quality of Life After Restrictive Procedures: A Prospective Study

Quality of life improves after bariatric surgery. However, long-term results and the influence of reoperations are not well known. A prospective quality of life assessment before, 1 and 7 years after laparoscopic adjustable gastric banding (LAGB) and vertical banded gastroplasty (VBG) was performed in order to determine the influence of reoperations during follow-up. One hundred patients were included in the study. Fifty patients underwent VBG and 50 LAGB. Patients completed the quality of life questionnaires prior to surgery and two times during follow-up. Health-related quality of life (HRQoL) questionnaires included the Nottingham Health Profile I and II and the Sickness Impact Profile 68. Follow-up was 84% with a mean duration of 84 months (7 years). During follow-up, 65% of VBG patients underwent conversion to Roux-en-Y gastric bypass while 44% of LAGB patients underwent a reoperation or conversion. One year after the procedure, nearly all quality-of-life parameters significantly improved. After 7 years, the Nottingham Health Profile (NHP)-I domain “physical ability”, the NHP-II and the SIP-68 domains “mobility control”, “social behavior”, and “mobility range” were still significantly improved in both groups. The domains “emotional reaction”, “social isolation” (NHP-I), and “emotional stability” (SIP-68) remained significantly improved in the VBG group while this was true for the domain “energy level” (NHP-I) in the LAGB group. Both the type of procedure and reoperations during follow-up were not of significant influence on the HRQoL results. Weight loss and decrease in comorbidities were the only significant factors influencing quality of life. Restrictive bariatric surgery improves quality of life. Although results are most impressive 1 year after surgery, the improvement remains significant after long-term follow-up. Postoperative quality of life is mainly dependent on weight loss and decrease in comorbidities and not on the type of procedure or surgical complications

Minimally invasive surgery and cancer: controversies part 1

Perhaps there is no more important issue in the care of surgical patients than the appropriate use of minimally invasive surgery (MIS) for patients with cancer. Important advances in surgical technique have an impact on early perioperative morbidity, length of hospital stay, pain management, and quality of life issues, as clearly proved with MIS. However, for oncology patients, historically, the most important clinical questions have been answered in the context of prospective randomized trials. Important considerations for MIS and cancer have been addressed, such as what are the important immunologic consequences of MIS versus open surgery and what is the role of laparoscopy in the staging of gastrointestinal cancers? This review article discusses many of the key controversies in the minimally invasive treatment of cancer using the pro–con debate format